Health sector decentralisation in Tanzania: Analysis of decision space in human resources for health management

2019 ◽  
Vol 34 (4) ◽  
pp. 1265-1276
Author(s):  
Ramadhani Kigume ◽  
Stephen Maluka
Keyword(s):  
Human Resources ◽  
Health Management ◽  
Human Resources For Health ◽  
Health Sector ◽  
Decision Space

scholarly journals Cross-national comparisons of human resources for health – what can we learn?

2005 ◽  
Vol 1 (1) ◽  
pp. 59-78 ◽  
Author(s):  
CARL-ARDY DUBOIS ◽  
MARTIN MCKEE
Keyword(s):  
Human Resources ◽  
Comparative Studies ◽  
Human Resources For Health ◽  
Health Sector ◽  
International Health ◽  
Comparative Approach ◽  
Generative Capacity ◽  
International Comparative ◽  
Context Specific ◽  
Cross National

After a long period of neglect, the issue of human resources for health (HRH) has recently emerged as a core component on the international health agenda, with policy makers increasingly eager to learn from experience elsewhere. This article investigates systematically the opportunities and challenges associated with the use of cross-national comparisons of HRH policies and practices. It reviews the evidence in favour of using international comparative studies on HRH, discusses emerging opportunities for developing a cross-national research agenda to guide HRH policies in Europe, and highlights obstacles which may hinder the implementation of comparative studies on HRH. While demonstrating many opportunities offered by the comparative approach to improve understanding of human resources processes in the health sector, this article also emphasizes the dangers of simplistic pleas for the transfer of human resource policies without taking into account the context-specific factors and the generative capacity of the social actors in the design and implementation of policy changes.

scholarly journals Tracking health sector priority setting processes and outcomes for human resources for health, five-years after political devolution: a county-level case study in Kenya

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Joshua Munywoki ◽  
Nancy Kagwanja ◽  
Jane Chuma ◽  
Jacinta Nzinga ◽  
Edwine Barasa ◽  
...  
Keyword(s):  
Service Delivery ◽  
Human Resources ◽  
Priority Setting ◽  
Human Resources For Health ◽  
Health Sector ◽  
Health Service Delivery ◽  
County Level ◽  
Health Coverage ◽  
Middle Income

Abstract Background Health sector priority setting in Low and Middle-Income Countries (LMICs) entails balancing between a high demand and low supply of scarce resources. Human Resources for Health (HRH) consume the largest allocation of health sector resources in LMICs. Health sector decentralization continues to be promoted for its perceived ability to improve efficiency, relevance and participation in health sector priority setting. Following the 2013 devolution in Kenya, both health service delivery and human resource management were decentralized to county level. Little is known about priority setting practices and outcomes of HRH within decentralized health systems in LMICs. Our study sought to examine if and how the Kenyan devolution has improved health sector priority setting practices and outcomes for HRH. Methods We used a mixed methods case study design to examine health sector priority setting practices and outcomes at county level in Kenya. We used three sources of data. First, we reviewed all relevant national and county level policy and guidelines documents relating to HRH management. We then accessed and reviewed county records of HRH recruitment and distribution between 2013 and 2018. We finally conducted eight key informant interviews with various stakeholder involved in HRH priority setting within our study county. Results We found that HRH numbers in the county increased by almost two-fold since devolution. The county had two forms of HRH recruitment: one led by the County Public Services Board as outlined by policy and guidelines and a parallel, politically-driven recruitment done directly by the County Department of Health. Though there were clear guidelines on HRH recruitment, there were no similar guidelines on allocation and distribution of HRH. Since devolution, the county has preferentially staffed higher level hospitals over primary care facilities. Additionally, there has been local county level innovations to address some HRH management challenges, including recruiting doctors and other highly specialized staff on fixed term contract as opposed to permanent basis; and implementation of local incentives to attract and retain HRH to remote areas within the county. Conclusion Devolution has significantly increased county level decision-space for HRH priority setting in Kenya. However, HRH management and accountability challenges still exist at the county level. There is need for interventions to strengthen county level HRH management capacity and accountability mechanisms beyond additional resources allocation. This will boost the realization of the country’s efforts for promoting service delivery equity as a key goal – both for the devolution and the country’s quest towards Universal Health Coverage (UHC).

Caring for the Caregivers Through Healthy Human Resource Practices

2020 ◽  
Vol 16 (2) ◽  
pp. 1-7 ◽  
Author(s):  
Mihir Dilip Kalambi
Keyword(s):  
Human Resources ◽  
Human Resource ◽  
Health Management ◽  
Human Resources For Health ◽  
Pharmaceutical Companies ◽  
Human Resource Professionals ◽  
Healthy Human ◽  
Quality Health Care ◽  
Quality Health ◽  
High Quality Health Care

India has a colossal shortage of human resources for health. The management of human resources in a healthcare institution is vital to enable the delivery of efficient and effective medical services and to achieve patient satisfaction. Everyone proclaims that the human asset is the most important asset. On the other side, health is declared to be one of the most important wealth. Hospitals and pharmaceutical companies constitute two arms of the “health management/ maintenance” effort of humanity. Human resource professionals face many hurdles in their attempt to deliver high-quality health care to citizens. Some of these constraints include budgets, lack of congruence between different stakeholders' values, absenteeism rates, high rates of turnover, and low morale of health personnel.

scholarly journals Examining health sector stakeholder perceptions on the efficiency of county health systems in Kenya

2021 ◽  
Vol 1 (12) ◽  
pp. e0000077
Author(s):  
Lizah Nyawira ◽  
Rahab Mbau ◽  
Julie Jemutai ◽  
Anita Musiega ◽  
Kara Hanson ◽  
...  
Keyword(s):  
Human Resources ◽  
Health System ◽  
Health Systems ◽  
Human Resources For Health ◽  
Health Sector ◽  
System Efficiency ◽  
Finance Management ◽  
Political Interests ◽  
Management Capacity ◽  
Health System Efficiency

Efficiency gains is a potential strategy to expand Kenya’s fiscal space for health. We explored health sector stakeholders’ understanding of efficiency and their perceptions of the factors that influence the efficiency of county health systems in Kenya. We conducted a qualitative cross-sectional study and collected data using three focus group discussions during a stakeholder engagement workshop. Workshop participants included health sector stakeholders from the national ministry of health and 10 (out 47) county health departments, and non-state actors in Kenya. A total of 25 health sector stakeholders participated. We analysed data using a thematic approach. Health sector stakeholders indicated the need for the outputs and outcomes of a health system to be aligned to community health needs. They felt that both hardware aspects of the system (such as the financial resources, infrastructure, human resources for health) and software aspects of the system (such as health sector policies, public finance management systems, actor relationships) should be considered as inputs in the analysis of county health system efficiency. They also felt that while traditional indicators of health system performance such as intervention coverage or outcomes for infectious diseases, and reproductive, maternal, neonatal and child health are still relevant, emerging epidemiological trends such as an increase in the burden of non-communicable diseases should also be considered. The stakeholders identified public finance management, human resources for health, political interests, corruption, management capacity, and poor coordination as factors that influence the efficiency of county health systems. An in-depth examination of the factors that influence the efficiency of county health systems could illuminate potential policy levers for generating efficiency gains. Mixed methods approaches could facilitate the study of both hardware and software factors that are considered inputs, outputs or factors that influence health system efficiency. County health system efficiency in Kenya could be enhanced by improving the timeliness of financial flows to counties and health facilities, giving health facilities financial autonomy, improving the number, skill mix, and motivation of healthcare staff, managing political interests, enhancing anticorruption strategies, strengthening management capacity and coordination in the health sector.

scholarly journals THE INFLUENCE OF MOTIVATION ON THE PERFORMANCE OF NURSING OFFICERS IN DEVOLVED UNITS, A CASE OF NYERI COUNTY, KENYA

2021 ◽  
Vol 7 (1) ◽  
pp. 19-36
Author(s):  
Jeremiah Ongori ◽  
Nelia Muiruri ◽  
Kulimankudya Vasco
Keyword(s):  
Human Resources ◽  
Human Resources For Health ◽  
Health Sector ◽  
Mean Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Descriptive Research ◽  
Nursing Services ◽  
To Come ◽  
Chi Square Analysis

Purpose: The management of human resources in healthcare institutions is vital to enable the delivery of efficient and effective medical and nursing services and to achieve clientele satisfaction. Motivation of human resources for health enhance quality service provision hence better outcomes. This study therefore sought to establish the influence of motivation on the performance of nursing officers, in devolved units, a case of Nyeri County, Kenya. Methodology: This study adopted a cross sectional descriptive research design. The respondents constituted all nursing staffs and managers in Nyeri County health facilities and at the County Director’s Office. Stratified random sampling was used to come up with a sample of 248 respondents. Data was collected using questionnaire. Descriptive statistics were used in the analysis of data with the help of SPSS 23. Chi-square analysis was used to establish relationships. Findings: The researcher found that motivation of nurses was not well done with a mean of 2.84, SD=1.090, and there were no upgrading and promotion opportunities (M=1.81, SD=1.133) for nurses in the county. There was a moderate performance of nurses with a mean value of 3.75, SD=1.100. Chi-square analysis showed that motivation (χ2 = 28.860, df=16, p=0.025) significant at 95% confidence level. The Cramer’s V value was positive indicating that motivation (v=0.473) enhance performance. Contribution to theory, practice and policy: The study concluded that motivation influences the performance of nursing officers, in devolved units in Kenya. Specifically, motivation approaches and techniques used in the health sector should be overhauled and/or reviewed as they are not effective. In particular, remuneration of staffs who have upgraded should be reviewed according to human resources policy.

scholarly journals Examining Health Sector Stakeholder Perceptions on the Efficiency of County Health Systems in Kenya

2020 ◽  
Author(s):  
Lizah Nyawira ◽  
Rahab Mbau ◽  
Julie Jemutai ◽  
Kara Hanson ◽  
Sassy Molyneux ◽  
...  
Keyword(s):  
Public Finance ◽  
Human Resources ◽  
Health System ◽  
Health Systems ◽  
Human Resources For Health ◽  
Health Sector ◽  
System Efficiency ◽  
Efficiency Gains ◽  
Finance Management ◽  
Health System Efficiency

Efficiency gains is a potential strategy to expand Kenyas fiscal space for health. We explored health sector stakeholders understanding of efficiency and their perceptions of the factors that influence the efficiency of county health systems in Kenya. We collected data during a stakeholder engagement workshop. Workshop participants included health sector stakeholders from the national ministry of health and 10 (out 47) county health departments, and non-state actors in Kenya. We divided stakeholders into three groups and carried out facilitated group discussions followed by whole group feedback and discussion session. A total of 25 health sector stakeholders participated. We analysed data using a thematic approach. Health sector stakeholders indicated the need for the outputs and outcomes of a health system to be aligned to community health needs. They felt that both hardware aspects of the system (such as the financial resources, infrastructure, human resources for health) and software aspects of the system (such as health sector policies, public finance management systems, actor relationships) should be considered as inputs in the analysis of county health system efficiency. They also felt that while traditional indicators of health system performance such as intervention coverage or outcomes for infectious diseases, and reproductive, maternal, neonatal and child health (RMNCH) are still relevant, emerging epidemiological trends characterized by an increase in the burden of non-communicable diseases (NCDs) should also be considered. The stakeholders identified public finance management, human resources for health, political interests, corruption, management capacity, and poor coordination as factors that influence the efficiency of county health systems. An in-depth examination of the factors that influence the efficiency of county health systems could illuminate potential policy levers for generating efficiency gains. Mixed methods approaches could facilitate the study of both hardware and software factors that are considered inputs, outputs or factors that influence health system efficiency.

scholarly journals Unpacking the policy landscape for implementing an Information Communication Technology (ICT) based in Human Resources Management tool in government health sector in Bangladesh: Findings from a policy review

2021 ◽  
Author(s):  
Dipika Shankar Bhattacharyya ◽  
Goutam Kumar Dutta ◽  
Iffat Nowrin ◽  
Sohana Shafique ◽  
Md. Zahidul Islam ◽  
...  
Keyword(s):  
Human Resources ◽  
Human Resources For Health ◽  
Qualitative Content Analysis ◽  
Human Resources Management ◽  
Health Sector ◽  
Policy Coordination ◽  
Management Tool ◽  
Monitoring Strategy ◽  
Digital Tool ◽  
Resources Management

Abstract Introduction: In Bangladesh, to address the challenges of ensuring adequate human resources for health (HRH), the government began implementing a digital tool for HRH management in 2017. However, evidence suggests institutionalizing such tools in low-and-middle-income-countries are impeded by policy aspects like implementation strategy and poor regulatory framework. We aimed to explore factors in the current policy landscape that might facilitate and challenge the implementation of the tool in Bangladesh.Methods: We conducted a review of policies related to ICT implementation and human resources management in health sector in Bangladesh using qualitative content analysis method. Twelve policies have been identified and comprehensive reading was done to ascertain common themes and patterns. A document analysis matrix was developed to synthesize and help interpreting the findings. Results: Regarding facilitators, strong upstream level commitments were reflected in the content of policies in terms of setting out specific objectives, targets, timeline, and budget allocation. However, lack of explicit monitoring strategy and extent of stakeholders’ engagement was not well-defined, ultimately create chances for making downstream implementation disjointed. In addition, effective coordination among stakeholders and different HRH and ICT policies could be strengthened. Discussion: Findings support the current discourse that national commitment plays a vital role in integration of ICTs in health services. However, well-defined monitoring strategy and inter-ministry and intra-ministry policy coordination is crucial.

scholarly journals Challenges and policy opportunities in nursing in Saudi Arabia

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Mohammed Alluhidan ◽  
Nabiha Tashkandi ◽  
Fahad Alblowi ◽  
Tagwa Omer ◽  
Taghred Alghaith ◽  
...  
Keyword(s):  
Human Resources ◽  
Rural Areas ◽  
Health Workers ◽  
Human Resources For Health ◽  
Health Sector ◽  
Postgraduate Education ◽  
Work Load ◽  
Nursing School ◽  
Quality Healthcare ◽  
And Gender

Abstract Background The Kingdom of Saudi Arabia’s (KSA) health sector is undergoing rapid reform in line with the National Transformation Program, as part of Saudi’s vision for the future, Vision 2030. From a nursing human resources for health (HRH) perspective, there are challenges of low nursing school capacity, high employment of expatriates, labor market fragmentation, shortage of nurses in rural areas, uneven quality, and gender challenges. Case presentation This case study summarizes Saudi Ministry of Health (MOH) and Saudi Health Council’s (SHCs) evaluation of the current challenges facing the nursing profession in the KSA. We propose policy interventions to support the transformation of nursing into a profession that contributes to efficient, high-quality healthcare for every Saudi citizen. Key to the success of modernizing the Saudi workforce will be an improved pipeline of nurses that leads from middle and high school to nursing school; followed by a diverse career path that includes postgraduate education. To retain nurses in the profession, there are opportunities to make nursing practice more attractive and family friendly. Interventions include reducing shift length, redesigning the nursing team to add more allied health workers, and introducing locum tenens staffing to balance work-load. There are opportunities to modernize existing nurse postgraduate education, open new postgraduate programs in nursing, and create new positions and career paths for nurses such as telenursing, informatics, and quality. Rural pipelines should be created, with incentives and increased compensation packages for underserved areas. Conclusions Critical to these proposed reforms is the collaboration of the MOH with partners across the healthcare system, particularly the private sector. Human resources planning should be sector-wide and nursing leadership should be strengthened at all levels.

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